Inner Space

A camera used in space exploration to study planets and distant galaxies may soon travel to your neighborhood operating room. Neurosurgeons and researchers at Cedars-Sinai Medical Center and the Maxine Dunitz Neurosurgical Institute are adapting a camera on loan from NASA’s Jet Propulsion Laboratory to focus on brain tumor tissue.

The highly sensitive camera is placed near the surgical field, recording images as the neurosurgeon exposes and removes the tumor. Images are not used in decision-making or surgical technique but later correlated with tumor appearance, laboratory findings, and MRI and CT scans to assess the ultraviolet technology’s value in the operating room.

The ultraviolet camera could give surgeons a real-time view of changes invisible to the naked eye and unnoticeable even with the magnification provided by current medical imaging technologies. The pilot study seeks to determine if the camera provides visual details that might help surgeons distinguish areas of healthy brain from deadly tumors called gliomas. The tumors’ far-reaching tentacles pose big challenges for neurosurgeons: Taking out too much normal brain tissue can have catastrophic consequences, but stopping short of total removal gives remaining cancer cells a head start on growing back.

Because tumor cells are more active and require more energy than normal cells, a specific chemical (nicotinamide adenine dinucleotide hydrogenase or NADH) accumulates in tumor cells but not in healthy cells. NADH emits ultraviolet light that may be captured by the camera and displayed in a high-resolution image.

Neurosurgeon Ray Chu, MD, is leading the study with co-principal investigator Babak Kateb, MD, research scientist at Cedars-Sinai’s Maxine Dunitz Neurosurgical Institute and chairman of the board of the Society for Brain Mapping and Therapeutics. “The ultraviolet imaging technique may provide a ‘metabolic map’ of tumors that could help us differentiate them from normal surrounding brain tissue, providing useful, real-time, intraoperative information,” says Dr. Chu.